J Pediatr Infect Dis 2013; 08(03): 125-129
DOI: 10.3233/JPI-130392
Georg Thieme Verlag KG Stuttgart – New York

Outbreak of pediatric Scrub Typhus in South India: A preliminary report

Selvaraj Stephen
a  Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
,
Gandhi Kandhakumari
a  Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
,
Shanmugam Manohar Vinithra
a  Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
,
Jothimani Pradeep
a  Department of Microbiology, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
,
Chandrasekaran Venkatesh
b  Department of Pediatrics, Mahatma Gandhi Medical College and Research Institute, Pondicherry, India
,
Venkatachalam Namachivayam
c  Krishna Hospital and Research Foundation, Cuddalore, India
› Author Affiliations

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Further Information

Publication History

08 November 2012

17 January 2013

Publication Date:
28 July 2015 (online)

Abstract

Contrary to the earlier view that Scrub Typhus (ST) is a disease of the Far East, it is now known to be more widely prevalent. In India, ST has now been reported from several areas where it was previously unknown. An outbreak of ST involving 40 children in a small hamlet in Southern India during five cooler months, November, 2011 to March, 2012 is described in this paper. The clinical suspicion was based on fever along with features such as presence of an eschar, hepatomegaly, thrombocytopenia, raised hepatic enzymes, etc. A presumptive diagnosis of ST was made when the rapid immunochromatography test (RICT) for ST IgM/IgG/IgA was positive. All but two samples (95%) were later found positive by conventional ELISA for ST IgM, with many showing agglutinins for Proteus OXK antigen with varying titers. Children responded well to treatment with azithromycin (37) or doxycycline (3) with defervescence within one to three days. Most children were in the age group of 0–5 years (47.5%) and boys (67.5%) outnumbered girls. We recommend that ST has to be considered in the differential diagnosis when investigating outbreaks of unexplained fever in children in India.